How Africa Became the Victim of a Non-Existent Epidemic of HIV/AIDS

By Neville Hodgkinson

AIDS; Virus or Drug Induced?

Global Retreat Centre, Brahma Kumaris World Spiritual University, Oxford, UK

It has become increasingly clear during the 1990's that in prosperous, developed countries, AIDS is remaining almost exclusively confined to people with clearly defined risks to their immune system regardless of HIV. These risks include heavy drug use, promiscuous receptive anal intercourse, or, as with the injections given to patients with haemophilia before the arrival of high purity Factor 8, repeated exposure to other people's blood. In Britain, out of a cumulative total of 6929 cases of AIDS in the first ten years of the epidemic, only 63 were in heterosexuals who were not obvious members of one of the known risk groups. In the United States, a 1992 National Research Council report found that many geographical areas and population groups were virtually untouched by AIDS, and would probably remain so.

These facts do not fit the theory that the world is in the grip of a deadly new infectious disease, putting at risk almost all sexually active people. However, that theory appeared to gain support from reports that millions of Africans are HIV-infected, and that hundreds of thousands are dying from the disease, with men and women equally at risk. What is happening to Africa today, it was argued, should serve as a warning of what may happen to the rest of the world tomorrow, even if it takes longer than had been expected.

In March, 1993, a television documentary was shown in Britain which challenged the by now conventional view of Africa as a land devastated by AIDS. It was based on a two-month investigation in Uganda and the Ivory Coast, and was made by Meditel, an independent company that had previously aired the views of scientists who argue HIV is not the cause of AIDS. It concluded that Africa was not in the grip of an AIDS epidemic, but that panic over the disease was leading to a tragic diversion of resources from genuine medical needs.

The film crew were accompanied during their inquiries by Dr. Harvey Bialy, a scientist with long experience of Africa, whom I interviewed at the time for an article in The Sunday Times. He had concluded there was 'absolutely no believable, persuasive evidence that Africa is in the midst of a new epidemic of infectious immuno-deficiency'. But because international funds were available for AIDS and HIV work, politicians and health workers had an incentive to classify traditional African diseases as AIDS. The problem was compounded by the fact that HIV testing was frequently misleading in Africa, as the tests reacted to antibodies to other diseases, producing high rates of false positives.

Bialy, a microbiologist working as research editor of Bio/Technology magazine, has been visiting Africa since 1975, and has spent a total of eight years working there. On the face of it, this gave him considerably more authority than the large numbers of western scientists and other workers whose first exposure to the continent was brought about by AIDS.

He was angry that so many damaging claims had been made about AIDS in Africa on the basis of so little science. 'The only utterly new phenomenon I have seen is in the drug-abusing prostitutes in Abidjan in the Ivory Coast', he told me. 'These girls come from Ghana, from families of prostitutes who are brought in by the busload. They have been doing this for generations, and never became sick until now. What is new is that these girls are addicted to viciously adulterated, smokeable heroin and cocaine. It completely destroys them. They look exactly like the inner-city crack-addicted prostitutes of the United States.'

'Otherwise, I have seen malaria, tuberculosis, diarrhoeal diseases, which arguably have got more severe; but by all the laws of scientific reasoning this is caused by the general economic decline in these countries, the decline of health care and the development of drug-resistant strains. All these things can explain exactly what is going on much more efficiently and persuasively, and to much greater good for the public health, than saying the diseases are being made worse by HIV'.

Our four-column story about these and other doubts, headlined 'Epidemic of AIDS in Africa 'a tragic myth', brought a crop of contrary assertions, but no evidence in rebuttal. My confidence in the story was further boosted by an astonishing statement Bialy had made about the HIV test.

Bio/Technology had a paper in press, he told me, which did more than highlight a problem with false positives: it challenged the very basis of the test as indicating the presence of a specific virus, arguing that it had never been validated against the accepted 'gold standard' for a diagnostic test, isolation of the virus itself.

I found this hard to take in, and did not pursue the story further immediately. But over subsequent weeks, I studied the paper concerned and corresponded with the main author, Eleni Papadopulos-Eleopulos, a biophysicist at the Royal Perth Hospital. To my continuing astonishment I found that there was indeed a mass of evidence, pulled together in Eleopulos's enormous review article, that what had come to be called 'the AIDS test' was scientifically invalid. The proteins detected by the test kits were not specific to a unique retrovirus. Positive results were produced in people whose immune systems had been activated by a wide variety of conditions, including tuberculosis, multiple sclerosis, malaria, malnutrition, and even a course of flu jabs. Patients with AIDS, and promiscuous gay men leading lives likely to expose their immune systems to multiple challenges, were certainly much more likely to test positive than healthy Americans, but for reasons that need not have anything to do with a deadly new virus.

The possible implications of the Bio/Technology article for an understanding of AIDS in Africa were clearly enormous. African countries were those where the tests might be at their most meaningless, because of the widespread ill-health caused by malnutrition and associated chronic diseases. Had an entire continent been panicked by western scientists into believing it was in the grip of a deadly epidemic, on the basis of a test that had never been shown to be valid for the retrovirus whose presence it was claimed to detect?

I faxed the article to four virus experts in case some glaring error invalidating its reasoning had been missed by Bio/Technology. One did not reply, and another preferred not to comment. A third, Dr. Philip Mortimer, of the Virus Reference Division at Britain's Central Public Health Laboratory, wrote a courteous reply acknowledging that the article 'does make some fair points about the weakness of the western blot test when it is used incautiously and without follow­up'. He added, however, that 'the situation it describes is not typical of this country where initial positive serological (antibody) screening tests are confirmed by (i) further investigations, usually a combination of different ELISA assays but sometimes including Western Blot and (ii) a test of a follow­up specimen. Only if the positive reactions on both specimens are confirmed, usually in a reference laboratory, is a positive report issued'. Perhaps this more stringent procedure helped to explain why Britain had only some 23 000 seropositive people, compared with an estimated 1 million in the United States and multi­millions in Africa. But Eleopulos et al. had not just criticised the Western Blot test. They had cited evidence indicating that the ELISA test might be equally meaningless. In Russia in 1990, for example, out of 20 000 positive screening tests, only 112 were confirmed using western blot. A similar study in 1991 confirmed only 66 out of approximately 30 000 positive test results. Clearly, by using multiple tests giving very different results, false positives would be greatly reduced. But this still did not answer Eleopulos's charge that there was nothing in the literature to indicate why any of the tests should be considered reliable as indicating the presence of a specific retrovirus. Besides, even if the damage done by false positives was being reduced in the UK by repeated testing, that was no comfort with regard to the situation in Africa, where because of cost considerations, most HIV diagnoses were being made on the basis of a single test.

Dr. Mortimer also commented that diagnostic capability had recently been advanced by the introduction of a commercial polymerase chain reaction assay for detecting minute quantities of HIV genetic material.

'Comparison of results using this procedure with those obtained by antibody tests show a very close correlation confirming the reliability of HIV antibody tests', he wrote. However, as the Bio/Technology paper pointed out, this correlation might be the result of some quite different cause common to both the PCR test and the antibody test. PCR signalled the presence of only a small stretch of genetic material; perhaps it was picking up the presence of a sequence made detectable by the same stimulus as that which caused a person to test antibody­positive, a stimulus which need not have anything to do with 'HIV'. The Bio/Technology paper cited evidence in support of this idea. For example, a positive PCR reverted to negative when exposure to risk factors was discontinued; and monocytes from HIV­positive patients in which no HIV DNA could be detected, even by PCR, became positive for HIV RNA after immune activation by co­cultivation with activated T­cells.

The fourth virus expert was Professor Robin Weiss, head of the Chester Beatty Laboratories at the Institute of Cancer Research, London, who with Dr. Richard Tedder, a virologist at the Middlesex Hospital in London, developed and patented Britain's first HIV test in conjunction with the Wellcome drug company. Dr. Weiss took the trouble to write a two­page letter concerning the Bio/Technology paper. His tone was set in the first paragraph: 'It is the sort of paper I would have stopped reading by paragraph 5 if you hadn't requested an opinion'. Later, he commented: 'Sorry, if the authors were my students, I'd mark this essay B­minus. Of the 1000 or so papers on HIV/AIDS that must have been published in the last six months, I'd put this in the bottom 10% for being worth reporting'. He acknowledged that the paper might have had some merit if it had been published around 1986/7, as 'there were serious difficulties and much variation in assessing Western Blot data, and some of the ELISA tests were still giving false positives'. But since then, he argued, the tests had been greatly improved because they used HIV antigens produced in bacteria by recombinant DNA technology, rather than grown from sera taken from AIDS patients.

It seemed to me that he had not answered the central complaint, that no one had ever established that the proteins held to indicate the active presence of HIV really are related to the virus in people who test positive, as opposed to other possibilities raised by the Bio/Technology authors. I wrote back along those lines. Robin Weiss responded with a short, unreferenced assertion: 'As I wrote, that might have been a valid argument six years ago, but not today as the proteins have been specific for some years'.

On August 1, 1993, the Editor ran our most challenging story to date across the top of the front page. The headline read: 'New Doubts Over AIDS Infections As HIV Test Declared Invalid'. The story began:

The 'AIDS test' is scientifically invalid and incapable of determining whether people are really infected with HIV, according to a new report by a team of Australian scientists who have conducted the first extensive review of research surrounding the test.

Doctors should think again about its use, say the authors. 'A positive HIV status has such profound implications that nobody should be required to bear this burden without solid guarantees of the verity of the test and its interpretation', they conclude. The findings, likely to cause intense debate in the medical fraternity and anguish for many HIV­positive people, are contained in an article published by the respected science journal, Bio/Technology. Many people who appear to be infected by HIV, say the researchers, can be suffering from other conditions such as malaria or malnutrition that produce a positive result in the test. Even flu jabs can produce the same effect. As a result, predictions by the World Health Organisation that millions are set to die because of being HIV­positive may be wildly inaccurate. The paper also lends powerful support to the theory, held by growing numbers of scientists, that HIV is not the true cause of AIDS. One of its authors, Eleni Eleopulous, a biophysicist at the Royal Perth Hospital, said this weekend: 'There is no proof that people labelled as 'HIV­positive' are infected with such a retrovirus. We should really question the role of HIV in the causation of AIDS.'

The claims were so at odds with conventional thinking on this enormously important subject that I had been nervous of writing the article, having already had to cope with huge waves of fierce criticism and comment in relation to previous articles questioning the HIV theory of AIDS. But this time, there was hardly a word of protest, let alone any arguments of rebuttal. No scientific papers to validate the tests. And no comment elsewhere in the media. We were being privately 'rubbished' by the AIDS experts to whom specialist writers turn in such cases. But it seemed their case was too weak for them to wish to state it publicly.

This gave me the push I needed to undertake a venture that the Editor had long since approved, namely, to mount our own investigation of AIDS in Africa. Was the situation as described by Harvey Bialy in Uganda and Ivory Coast also true of other central African countries? On August 18, armed with the Bio/Technology paper, I flew to Nairobi, Kenya and began to make inquiries.

It soon became clear to me that because of the idea that HIV was lethal and rampant, there was a consensus belief that one could hardly be too alarmist in public pronouncements about Aids. The Kenya Times, for example, earlier that year had reported estimates by the Kenya Medical Research Institute (KEMRI) that the country had about 100 000 AIDS cases, and about one million people 'who have the AIDS­causing virus'. It added that 'once a person is infected with the killer disease, his next step is definitely death'. But the figures were impressionistic. They were put out by researchers who had been alarmed to find that about half of the people going to various hospitals for general medical reasons were testing positive. Perhaps the whole edifice of fear and concern sprang from a scientifically unvalidated test, and a misinterpretation of the meaning of a positive test result.

According to KEMRI's Dr George Gachihi, 'when you see a young man or woman die after a short illness, chances are that he succumbed to the AIDS disease'. It was that perspective which led the Kenya Times to report that 'thousands of Kenyans die each year from AIDS, though the certificates always indicate that they died from other causes'. When one looked at the figures through the perspective of the Bio/Technology critique, however, there was no longer any need to see the deaths as other than from the stated causes. Similarly, despite stories about hospitals being filled to overflowing with AIDS victims, when I visited the huge Kenyatta National Hospital in Nairobi I found that although there was immense overcrowding, only a handful of patients had been admitted with an AIDS diagnosis.

I also found that political factors were playing a part. Kenya had lost an estimated $300 m in desperately needed foreign currency in November 1991, when the industrialized world tried to force political and economic reform on the country by cutting aid. A recent crisis announcement on AIDS by the country's health minister was seen within the international aid community as an attempt to win back donor sympathy and funds, according to the journal Africa Confidential. 'A far­from­veiled theory in circulation says figures which show AIDS spiralling out of control have been massaged to extract sympathy', the journal said.

'In stark contrast to the recent past, when AIDS was a banned subject to protect the tourist industry, the press has started reporting ever more startling increases in AIDS cases and newspapers are competing for horror stories of AIDS deaths'.

It did seem to be true that doctors were reporting growing numbers of AIDS cases, especially among prostitutes. But in this latter group, the actual cause of death was often unknown. When a prostitute who had tested HIV­positive subsequently disappeared, it was assumed that she had gone back to her home town to die of AIDS. I also found that researchers knew nothing of the doubts over the HIV test, and had not established the extent to which the increase in cases of immune system dysfunction was genuinely the result of a new virus, as opposed to a consequence of an intensification in long­established threats to health. According to some observers, poverty had driven millions of women into prostitution, and young African males had also been drawn into the trade.

There was nothing to support the apocalyptic vision of Africa's future espoused by the World Health Organisation on the basis of its HIV statistics. I found in Kenya as elsewhere that the statistics were often based on small clinical surveys, with the results then writ large by computer to form an estimate for the country as a whole ­ and all this using a test which the Bio/Technology paper had shown to be unvalidated and probably invalid. One WHO official told me: 'AIDS is there. No doubt about it. And it is widespread and increasing. My colleagues in the other countries can tell you the same'. But she added frankly: 'If you come with this postulate that there are a lot of false HIV­positives, it is very difficult to tell'.

The first story I filed back to The Sunday Times focused on the experience of a remarkable doctor whom I met in Nairobi, Father Angelo D'Agostino. Then aged 67, he was a former surgeon who trained as a Jesuit priest and became a professor of psychiatry in Washington before going to Africa ten years previously. In 1992 he had founded Nyumbani, a hospice for abandoned and orphaned HIV­positive children, after finding that because of the panic over AIDS, nowhere else would take them in. Regardless of HIV, there were good reasons why the foundlings, whose plight he learned of through work with a local Barnardo's home, should often perish. Abandoned by their shocked and stigmatised HIV­positive mothers, the children died of multiple infections, malnutrition, and misery.

'People think a positive test means no hope, so the children are relegated to the back wards of hospitals which have no resources, and they die', D'Agostino said. 'They are very sick when they come to us. Usually they are depressed, withdrawn, and silent. Some have been in very poor conditions. But as a result of their care here, they put on weight, recover from their infections, and thrive. Hygiene is excellent, that they wouldn't have in the slums they have usually been living in. Nutrition is very good: they get vitamin supplements, cod liver oil, greens every day, plenty of protein. They are really flourishing. Even one that came in with TB is doing better now'.

A year on from opening the hospice, D'Agostino was puzzled. Elsewhere in Kenya and across sub­Saharan Africa, according to WHO, tens of thousands of children were dying because of HIV, usually in their first year. But most of the Nyumbani babies were thriving, as I knew from spending a couple of hours there with several of them crawling all over me. Only one of the first 45 children had been lost ­ a six­week­old who was so sick when she came that she had to go to hospital almost immediately, and died two weeks later.

In an extensive interview, D'Agostino told me: 'I'm a physician, and I bought the theory that HIV is the cause of AIDS. But there are not a lot of things I would die for, and certainly not a scientific hypothesis. In fact, I would welcome with open arms any proof that these children will be free of disease'.

'It is surprising. We expected more deaths, and a lot more serious illness. According to most predictions, the children should have died within two to three months of coming to us. Instead, we have now had to set up a nursery school, which I didn't think would be needed, and I'm planning to negotiate their entry into primary school'. He had also been preparing to establish group therapy for the mothers and other caregivers, to deal with their grief at the loss of the children. Instead, the only losses were happy ones: some of the children became HIV­negative, and were taken back by relatives or ordinary children's homes. Even those who persistently tested positive were staying well. 'I don't have any explanation for it. Will they be alive this time next year? I have no reason to doubt it: they are healthy'.

As my travels progressed, through Zambia, Zimbabwe and Tanzania, it became more and more obvious that there were great uncertainties over the extent of African AIDS. The belief that there was an epidemic had taken root in many people's minds, and some unexpected or unexplained deaths tended to be seen in the light of this belief. But was there really a new, clearly identifiable clinical condition?

In Lusaka, Zambia, I was told by Guy Scott, an MP and former cabinet minister, that the disease threatens to orphan 2 million children, and to take the lives of large numbers of staff in companies, public utilities, and government. 'It is ripping through the system. It is an absolute disaster', he said. Screening surveys conducted in late 1992 had found that as many as four out of ten sexually active people were testing HIV­positive, spurring the government into launching a new anti­AIDS campaign.

But several doctors at the University Teaching Hospital in Lusaka had a different view. They responded warmly to the Bio/Technology paper, finding that it reflected and helped to explain their own experience. They had been particularly puzzled by an enormous gap between reports of people testing HIV­positive, and the number of people reported as falling ill with AIDS ­ fewer than 1000 a year, in a nation of 8 million people.

Dr. Franci Kasolo, head of virology, said work in his department suggested the HIV figures could not be taken at face value. 'We have found a big problem with false positives', he said. 'When we repeat the tests, there are a lot of disparities in the results. A test kit from one manufacturer behaves differently from another's'. The conclusion was that 'most of our results are more or less compromised'.

Most of the country's 80 testing centres were unable to afford confirmatory Western Blot testing after an initial positive ELISA. And in any case, the Western Blot produced widely differing results. A third, rapid test had been shown to produce up to 40% false positive results.

Dr. Wilfrid Boayue, the WHO representative in Zambia, said the recent surveys had shown such a big increase in positive results compared with six to seven years previously, when the proportion was only about 5 to 8%, that he shared concern that the country was in the grip of an HIV epidemic. Kasolo, however, thought changes in the type of test kit used might contribute to the changing picture. He had a lot of experience with this, because international aid for developing countries is often tied to use of materials provided by the donor nations, and the donors keep changing.

'Most of the kits are supplied by the donors. If one decides not to provide funds any more, we move to another who will, and the kits come from that country instead. So the kits vary a lot: reporting can be high or low, depending on the kit. We have had individuals tested in one laboratory, and told they are positive, who move on to another, where they are negative. It is important that we address the whole issue of HIV in Africa scientifically. There is something going on that we do not understand'. Dr. Sitali Maswenyeho, a paediatrician at the University Teaching Hospital and former fellow in AIDS research at the University of Miami, said he had long argued against the HIV test. 'It's non­specific', he said. 'The test itself is killing a lot of people here. The stigma is doing the damage. We have malnutrition, bad water, poor sanitation, and when on top of that you are told you have an incurable disease, that really cuts off people's lives'.

Despite concerns over the validity of the HIV test, the presence of a severe form of immune system failure, affecting mainly sexually active people, was widely acknowledged. But there was argument over its causes. Kasolo maintained that a variety of sexually transmitted infections might be responsible, a view shared by many older Zambians. Others felt it might be associated with over­use of aphrodisiac drugs, made from plant sources.

David Chipanta, 22, an HIV­positive man helping with the work of an AIDS education and counselling organization, said: 'People in the villages tell us it is not new, but that it has become worse because of promiscuity'. Despite disagreeing with that view ­ he argued that promiscuity was itself nothing new ­ he supported the challenge to HIV testing.

In Zimbabwe, health authorities were convinced that AIDS was a real threat, but Dr. Timothy Stamps, the minister of health and child welfare, was also concerned that WHO and the 'AIDS industry' had fostered a damaging epidemic of what he called 'HIV­itis' in Africa. 'My basic worry is that it's distracting money and attention and personnel from the known problems such as malaria, tuberculosis, sexually transmitted diseases and safe motherhood', he said. He was particularly disturbed by WHO advice discouraging women who had tested HIV­positive from breast­feeding their babies.

Despite clear evidence confirming the thesis that the HIV story was gravely flawed, it was hard for me to be sure, when faced with widely differing views among those I met, whether or not some new, epidemic condition was afflicting Africa. But in Tanzania, I met two medically trained charity workers whose dramatic testimony provided the clearest evidence yet that the continent was not engulfed by an epidemic of AIDS ­ and a profound insight into how the story of an epidemic had come about.

In mid­life, after finding they could have no children of their own, Philippe and Evelyne Krynen trained in France as nurses, with a specialist qualification in tropical medicine, in order to be able to dedicate the rest of their lives helping Third World orphans. In 1988, they travelled through central Africa looking for a suitable place to set up a branch of the French charity Partage, which had agreed to support them. They heard that the remote Kagera province in northern Tanzania, where Africa's first cases of AIDS were diagnosed as far back as 1983, was now an epicentre of the disease, which had orphaned thousands of children.

After a three­day journey to the province in January 1989, a tour of the worst­hit places conducted by a local Lutheran bishop seemed to confirm everything they had been told. Whole villages were being destroyed, people were dying continuously in and around the main township of Bukoba, and HIV testing suggested up to half the sexually active population was infected.

Philippe, now 51, a former pilot, and Evelyne, 43, a teacher, prepared an illustrated report on their findings, Voyage des Krynen en Tanzanie, which was to prove a catalyst for world interest in the social impact of AIDS in Africa. It presented a dramatic picture: children alone in houses emptied of adults, or abandoned into the care of grandparents; a football team destroyed by the disease; old people sitting alone with their dead; black crosses painted at the entrances of AIDS­stricken homes.

'Here, AIDS does not choose its victims among marginal groups', they wrote. 'It touches the entire sexually active population, men and women alike. Extreme sexual liberty, a weak sense of hygiene and a lack of medical and social support have made the populations of these parts a particularly homogeneous risk group'.

As I reported in The Sunday Times, it was a message that Western medical and charitable agencies, urgently wanting to alert people to the perceived dangers of HIV and AIDS, were more than ready to hear. US, French and Belgian newspapers, magazines and television stations took up the story. Aspects of it are still being quoted around the world by AIDS organizations.

The couple explained to me that in common with many other Westerners who had seen the AIDS epidemic as a call to arms against the perils of ignorance and promiscuity, they had felt it was almost impossible to overstate the dangers. They helped one young villager write a letter to schoolchildren. It said so many of his team­mates had died that 'we can't play football any more ­ so behave, and you won't get the disease like we did here'. The letter featured in pamphlets prepared by a European Community AIDS prevention project and was distributed widely to schools in west Africa.

'When we came here we had the textbook knowledge of AIDS in our minds', Philippe said. 'That it is a sexually transmitted disease; that it would be very easily transmitted in Africa because other STDs are rampant; that many Africans are HIV­positive and would get full­blown AIDS after one or two years, faster than in Europe; and that the virus was passed from mother to child, affecting 50% of children. This was what we had learned from our medical studies. And the people who showed me what was happening here reinforced this belief. What I wrote in my journal was with 100% bonne conscience'.

Four years on, Partage Tanzanie was now employing some 230 full­time staff, who were helping 7000 children in 15 of Kagera's villages. There were 20 nurses, a doctor, a pharmacist, a laboratory technician, office workers and teachers; and scores of field workers who had got to know the children, caring for them at day centres, monitoring their health and ensuring they were well fed. As a result of the increasingly intimate understanding the Krynens acquired of the region and its people, allied to the questions the couple started asking arising from their own scientific training, a very different picture of what was going on started to emerge compared with their first impressions.

The first clue that there might be something wrong with the standard medical model of HIV and AIDS came when they started to try to organise help for children in the border villages. 'Our aim was to help the people help their children', Evelyne said. 'But in some of the villages we found nobody was interested in the future, or in the kids, any more. One reason, we thought, was that they had been told 40­50% were infected and were going to die, and this in a context where people were indeed dying a lot, because of poverty and an upsurge in malaria'. (Anti­malarial drugs had helped more children through to early adulthood, but left them still vulnerable to the disease. Previously, those who survived the illness in childhood were more likely to have lifelong immunity).

'The young people were convinced they were going to die anyway, so why should they think of the children or the future. We said that even if 50% are infected, 50% are not, so let us find out which are which. Then those who are free of the virus can think about the future again'.

A pilot study offering HIV tests to their own staff produced a shock: only 5% were positive, although almost all were young and sexually active. Perhaps they were unrepresentative, the Krynens though because their level of education was above average. So in 1992 they proposed a mass testing programme in Bukwali, a village on the border with Uganda where some of Africa's first AIDS cases had been reported nearly ten years previously.

Encouraged by the promise that a clinic would be established to give free treatment to anyone testing positive, about 850 people agreed to take part ­ almost the entire population aged between 18 and 60. This time, 13.7% were found to be HIV­positive, still much lower than the villagers had been led to believe. The Krynens found that a single positive test could not be relied on ­ repeat testing would frequently show the same patient to be negative. The villagers may have shown a higher rate of HIV­positives simply because they were older, with an average age of about 42 compared with 24 in the staff study. They had beer exposed for longer to 'whatever it is in Africa that can so readily cause the blood to test positive', as Evelyn put it.

'We have noticed that with the women, the more children they have, the more likely they are to be positive. We have five HIV­positive women on our staff, and all have children, but a stable life. It could be because being more in contact with doctors and hospitals, and taking more drugs, or even just giving birth, causes you to accumulate reactivity to the test. It may not have anything to do with a virus'.

The Krynens also found that when appropriate treatment was given to villagers who became ill with complaints such as pneumonia and fungal infections that might have contributed to an AIDS diagnosis, they usually recovered.

'All of a sudden you put all you have been told about the disease in the garbage can, and try to reconsider', Evelyne said. 'The 15 villages we have looked at are in the most affected area of a region that is supposed to be at the epicentre of AIDS in Africa. When you listen to the people, you find they had been shocked by some deaths where the effects on the body were very visual, with fungus infections and skin rashes. But these can be secondary effects of antibiotics, and the people who died with these conditions had all been treated before for conditions such as bronchitis. Nothing is sure; everything is just wind'.

Most of the first deaths reported as AIDS were in young men trading in black­market goods in the aftermath of the Ugandan war. It started at the border, where people were dealing in drugs as well as other goods, said Philippe. 'It's true this group had money and was affected with immune suppression and a wasting syndrome. But it was not because they had sex like rabbits that they died. This is what was put in people's minds by missionaries and other people, but whatever killed them was not sexually transmitted, because they have not killed their partners. They have not killed the prostitutes they were using; these girls are still prostitutes in the same place'.

'Was it a special booze? Was it an amphetamine or aphrodisiac? It is difficult to give more than hints, but when you listen to the people's descriptions of those first affected, you find they were saying they had been poisoned. If the local people said that, for two or three years before the word AIDS came to the region, why don't we believe them a bit, and look at what could have poisoned them'?

Today the couple are continuing to use the HIV test, 'just to prove that we have to stop doing this, that it has nothing to do with AIDS'. They are training their field workers not to mention HIV or AIDS, but instead to deal with any known disease they encounter with the best treatment available, regardless of the patient's HIV status. 'It is not known whether HIV causes AIDS', they say in a pamphlet produced for the team. 'It is time to come back to science and abandon magic thinking'. Philippe declares: 'There is no AIDS. It is something that has been invented. There are no epidemiological grounds for it; it doesn't exist for us'.

If Kagera is not, after all, in the grip of an epidemic of 'HIV disease', and if there is no AIDS, where have the thousands of orphans come from? The answer, say the Krynens, is that most of the children are not orphans at all. Their final disillusionment was to discover that although many children are raised by their grandparents, that is a long­standing cultural feature of the region.

'The parents expatriate themselves a lot', Philippe explains. 'They move away from the region, sending a little money, returning little or never, but still have many children in the village. They are outwardly orphans, but raised by the grandmother or grandfather. It has always been like this here; they may need help, but it has nothing to do with AIDS. Polygamy is also rampant here and they don't raise all the children. They select very few and the others are just made and abandoned'. Other children are born to prostitutes, who may spend much of the year away from the region, working in the cities.

'You come as a European and ask: 'Who has no mother or father?' They produce all these children, even though they have a mother or father in another place. We have been shown false orphans since the beginning ­ children who have parents who never died, but who will not show up any more. And when the parent has died, nobody has been asking why. It has nothing to do with an epidemic. Families just bring them as orphans, and if you ask how the parents died they will say AIDS. It is fashionable nowadays to say that, because it brings money and support'.

'If you say your father has died in a car accident it is bad luck, but if he has died from AIDS there is an agency to help you. The local people have seen so many agencies coming, called AIDS support programmes, that they want to join this group of victims. Everybody claims to be a victim of AIDS nowadays . . . It is good to know that this epidemic which was going to wipe out Africa is just a big bubble of soap'.

Posters warning of the dangers of ukimwi (AIDS) adorn the cabins of the Victoria, a steamer that ferries passengers on the nine­hour journey from Mwanza, on the southern shore of Lake Victoria, to Bukoba. When the Krynens first made the journey, they found a small town with only a handful of foreigners and few cars. Today, as the ferry arrives, the tiny port seizes up with vehicles, including the white Land Rovers and Toyotas characteristic of the numerous AIDS agencies that have flourished in much of central Africa.

'We have everybody coming here now ­ the World Bank, the churches, the Red Cross, the UN Development Programme, the African Medical Research Foundation ­ about 17 organizations reportedly doing something for AIDS in Kagera', Philippe said. 'It brings jobs, cars ­ the day there is no more AIDS, a lot of development is going to go away'.

The Krynens work hard. They keep files on all their donor families and careful records of how the money is spent. Their home, a modest bungalow on a hillside overlooking Lake Victoria, is the hub of the project, with its own HIV­testing laboratory. All day a stream of workers comes by to give feedback and take directions. A few children who have nowhere else to go live in an adjoining building. With such direct, practical help being given to suffering people, perhaps it does not matter too much whether the children are AIDS orphans or not. But the Krynens are angry because false information continues to be spread to Africa and the world.

'Africa is a market for many things, an experimental ground for many organizations and a 'good conscience' ground for many charities', Philippe said. 'It is very easy to 'do good' in Africa. It is so disorganised that the one who is doing the good is also the one reporting the good he is doing. So it is a perfect field for charity ­ the fake charity which is 99% of the charity in Africa, charity which benefits the benefactors. The Krynens felt strongly about this because of their own involvement in triggering an invasion of AIDS agencies to Kagera. They now know that the stories they told, of houses and villages abandoned because of AIDS, were untrue.

'The houses that were empty were closed because they were the second or third homes of someone in Dar es Salaam', said Philippe. And the black crosses painted outside homes were leftovers from a populalion census, not a warning of AIDS. 'I learned this later. I have never seen a village with no adults, where children are like wolves in the forest. You know who is responsible for these stories? Partly, Partage. We said that if we did not do something very quickly, these villages would be emptied of adults, and children would be like wild animals. The stories have been printed and reprinted, without the 'if' '.

'My medical studies led me to believe that AIDS was devastating and the people who showed me the situation here reinforced this belief. I jumped into this, and made others believe it. And now I know it was not true. But I know many more things that were not true. Nothing was true'.

'It is terrible to consider you have done so many things you thought worthwhile, when in fact you were misled. It is difficult to adjust afterwards. Nobody knows who is responsible for the first misinterpretation, but as time passes it gets bigger and bigger. These ideas were not based on any studies; they were just fashion. But when you are here, and you have to witness the reality of what happens in the field, you cannot agree with any of the statements they are making in Europe about AIDS in Africa. We discovered we were in a full­blown lie about AIDS. Everybody participates in this lie, willingly or not. No individual is responsible, but it is a big scandal'.

'The world has been brainwashed about AIDS. It has become a disease in itself, without the necessity of having sick people any more. You don't need AIDS patients to have an AIDS epidemic nowadays, because what is wrong doesn't need to be proved. Nobody checks; AIDS exists by itself'.

'We came here to help orphans of AIDS. Now we are facing a situation where there are no orphans and no AIDS. We are in the heart of AIDS country. You are talking to people who 'discovered' AIDS here, and who now say it is a lie. We expect to have to pay for what we say. It will be the price of truth'.

Articles I filed from Africa were often followed up or reprinted in regional and national newspapers there, after they had appeared in The Sunday Times. With so much money and prestige at stake, this caused some of the people I had interviewed to come under great pressure to recant. They responded differently to these pressures.

Father D'Agostino was upset to see the puzzlement and hope he had expressed in relation to the survival of his 'AIDS babies' put in the context of the wider critique of the HIV theory of AIDS that The Sunday Times had been airing. To the medical profession, this is a heresy, not just a different interpretation of the facts, and a press release he issued on September 17 on behalf of the Children of God Relief Institute, which runs Nyumbani, read more like a religious creed than a comment from a scientist. It stated:

Recently, the London Sunday Times ran a long front­page story and the Nairobi Nation an editorial page 'special report'. Both papers misconstrued the facts of the unfortunate life circumstances of the children at 'Nyumbani' in order to prove an erroneous thesis. While this does no harm to the children themselves, it does a grave disservice to the larger community because it panders to the all too prevalent mental process of denial. This denial only increases the universal and deadly threat of HIV/AIDS. In order to correct these errors, we must assert:

(1) We do believe in the 'germ' theory of disease as proposed by Louis Pasteur. This universally proven theory is accepted by compassionate and credible scientists worldwide.

(2) We believe that there is a virus designated 'HIV' which has been isolated and is responsible for the fatal disease called AIDS.

(3) Since there is no cure for the ravages of the HIV virus, we believe that the only strategy to contain and prevent spreading of the disease AIDS is for all sectors of society to join hands in creating awareness and, urge action in an appropriate manner.

(4) Compassion, understanding, care and respect for human dignity must fashion any program to help those suffering from HIV/AIDS.

(5) We invite any party so inclined to help our efforts to assist in alleviating the tragic plight of those voiceless HIV/AIDS sufferers ­ the abandoned child.

(6) We totally disagree with any scientifically unsubstantiable theory that denies the reality of the causation of the disease HIV/AIDS.

The uncertainties Father D'Agostino had clearly expressed in a recorded interview, as he pondered the surprising good health of his foundlings, were now gone, replaced by a reaffirmation of belief in the HIV doctrine of AIDS. I knew nothing of this press release at the time ­ I was still travelling through Africa, and had not even seen the Sunday Times ­ and although Father D'Agostino says he faxed a response to the article to the newspaper's office, it was never received there.

In fact, the first I knew of his dissatisfaction was when I received the following letter, dated October 22, after I had written to him on my return to London enclosing cuttings of my Africa articles.

Dear Neville,

I want to thank you for the courtesy of sending the article appearing in the 3rd October edition and also for the pleasant experience that we all had when you visited Nyumbani. That being said, I must confess to some reservations.

You and I look at the world with quite different perspectives. You, from that of a journalist and myself, as a committed medical man. Our goals are quite different. I, after having spent at least 14 full years in the pursuit of medical knowledge, am committed to using that eclectic knowledge for the good of mankind. I am not espousing any particular philosophy or theory when I attempt to enhance the body's (and mind's) natural healing powers. That being said then, I quite disagree with your point of view. I am trying to be charitable in assuming that you have taken this task for humanitarian reasons, but I must say there is a question about that at times.

I certainly question the Sunday Times approach to the problem because it is quite evident that they are more interested in selling copies rather than the pursuit of truth. They have no care for the terrible consequences to people when they are permanently and fatally injured by believing the misinformation that is being peddled. A primary principle in the practice of conventional medicine is that if one cannot do any good, at least do not do any harm. This principle is observed only in the breach by the Sunday Times because they are doing great harm without even considering the possibility . . . and for mere gold.

Another point: I was able to fax a response to the article but never got any sort of admission of reception or acknowledgement. Would it be possible for you to inquire as to whether or not they did receive my fax and what they plan to do about it, if anything?

Finally, I want to state that this is not a personal issue and I would look forward to your visiting us once again, but this time, being quite open about our stand with regard to the terrible consequences of the infection by the HIV virus.

With all best wishes, A. D'Agostino, SJ, MD

On October 29, I replied as follows:

Dear Father D'Agostino,

I was greatly distressed to receive your letter of October 22 today. Firstly, because neither I nor the Letters Editor had known anything of your sending a response to my article of October 3; and secondly, because of your evident distress over what you call the Sunday Times approach to the issue of HIV and AIDS. I had felt that my article was a straightforward description of what you had told me and what I had observed for myself. I also know how much both the Editor and myself have wanted to contribute to understanding about HIV and AIDS, and how wrong you are to allege that we are doing harm 'for mere gold'. Have you seen the other articles I filed? Some of the people involved in those have subsequently come under bitter attack from parties who feel both the truth and their own interests have been threatened, but perhaps the difference is that they were aware of what a contentious issue this is.

It is not possible to back away from these issues: the point of view to which the newspaper has been giving an airing is that immeasurable harm, including much loss of life resulting from panic and false diagnosis, is being done by the blind pursuit of the HIV hypothesis against much evidence of its inadequacies. Indeed, we quoted ­ accurately ­ Dr Timothy Stamps, Minister for Health and Child Welfare in Zimbabwe, as saying 'the HIV industry . . . is now in my view one of the biggest threats to health'.

Your own uncertainty was very clear when we met. What has happened to make you write as you did? I do apologise if you have been embroiled in a controversy against your wishes, but the strength of feeling on this issue should help to indicate to you that something may be terribly wrong in the view that your profession has currently espoused so dogmatically about the cause of AIDS.

I thank you for your kindness in emphasising that you do not see this as a personal issue. Please do send a copy of your original fax to the Letters Editor, with a copy in the post in case of further problems. Mark the letter clearly for the Letters Editor. I should also be grateful to receive a copy: the news desk fax, which is nearest to me, is ....

Neither I nor the newspaper ever received that fax from Father D'Agostino. He told me by phone, when the issue flared up again, that he had decided against sending it, after receiving my letter, feeling that it was by then too late. But that did not stop him making a statement the following January to the Independent on Sunday, a newspaper which has been most vociferous in Britain in promoting the official view on HIV and AIDS and in attacking my own reporting. In it, he condemned the 'gross distortions and quite incorrect implication' made as a result of my interviewing him, and declaring that he had received no acknowledgement of his original fax.

I like and admire Father D'Agostino and am sad that I caused him distress, but I feel quite sure we were right to run the article. The quotes directly attributed to him were taken verbatim from my recording and expressed his observations as a human being and a doctor, as opposed to a politician and defender of the HIV faith. I can understand his discomfort at the sweeping frontpage headline used on the story, 'Babies give lie to African AIDS'. There was also an unfortunate piece of editing, that attributed more uncertainty to him than he had expressed. The article I filed from Nairobi included a paragraph in which I wrote: 'The suspicion is growing that many 'AIDS' cases are really old diseases given a new name, though sometimes made worse by civil war and economic and social decline, and that people who test HIV­positive are not, as most have been led to believe, the victims of a new, inevitably lethal disease'. The edited version correctly stated that in common with growing numbers of scientists and doctors around the world, D'Agostino was beginning to question whether HIV really was the killer it had been made out to be. That was the purport of the entire interview, during which I had told him about the Bio/Technology paper and the reappraisal of the HIV theory of AIDS being sought by those doctors and scientists. But the article then went on to state that 'He, like them, suspects that many 'AIDS' cases are really old diseases given a new name . . .' etc., a suspicion I had not attributed to him.

His statement to the Independent on Sunday, however, made it plain that he was now putting all his doubts behind him. He said four children in his care had since died of AIDS out of a total of 55 with HIV, and that two or three others had AIDS. He had no doubt, the paper reported, that children infected with HIV would eventually succumb to AIDS.

Since my work in this field has so often shown me how that very expectation among doctors tends to become a self­fulfilling prophecy, I rang D'Agostino in disbelief to ask him if that was really what he now thought. Yes, he said, 'I never questioned the medical model; the only thing I questioned was why they didn't die at three, why they were still alive at seven. I never questioned that they would die. I know they will succumb'. There was 'no question' in his mind that the four had died of AIDS. In one, it had been carditis, that refused to clear up with the most up­to­date antibiotics. When I questioned whether that was an AIDS­defining illness, and asked him about the other deaths, Father D'Agostino grew angry and told me they died of HIV, and he was a doctor, and I had no right to question his clinical judgement.

D'Agostino told me he had come under a lot of pressure locally, in particular through medical channels, and I do not know what other pressures he had to bear. But they could hardly have been more intense than those that befell the Krynens after my article about their changed vision of AIDS in Africa. The European Community's AIDS Task Force, which had previously made a star of Philippe Krynen, now disowned him and cancelled a promise of funding for Partage. There were even attempts to have the couple thrown out of the country. They were also invited to ecant, and condemn the Sunday Times, as in a letter received from Dr. Angus Nicoll, consultant epidemiologist with Britain's Public Health Laboratory Service, who inquired through Partage's headquarters in France:

Further to my communication of December 20th I have been sent the attached letter and press release by Father D'Agostino in Kenya. As you will read they are complaining of some misrepresentation by the Sunday Times and are asking that the newspaper convey Dr. D'Agostino's views. I also attach a copy of the original article . . . After reading these letters I wondered whether Mr. and Mrs. Krynen had been fully happy with their coverage and had had any experience like Dr D'Agostino in trying to make a correction?

Philippe Krynen told me that he received the same letter again in January. The answer suggested by such an amazing approach, he said ­ though he did not actually send it ­ was 'questions put by the police are only answered in the presence of our lawyer'. In fact, he stood by and continues to stand by every word in our article.

In February 1994, the Journal of Infectious Diseases published the results of a study conducted in Kinshasa, Zaire, to try to establish whether HIV infection was associated with leprosy. About 70% of 57 leprosy patients, and 30% of a group of 39 contacts, tested positive according to two leading versions of ELISA. But after laboratory investigations, it was found that proteins from the leprosy agent were causing crossreactions with the 'HIV' test. When this was taken into account, the researchers concluded that in fact only two of the leprosy patients, and none of the contacts, were HIV­infected. Testing with Western Blot was even more misleading. It gave a positive reaction in 85% of the patients who were negative with the other tests. The authors, who included Harvard's Dr. Max Essex, one of the originators of the theory that HIV originated in Africa, pointed out that the microbe responsible for tuberculosis is in the same family of mycobacterial agents. They concluded that ELISA and Western Blot tests 'may not be sufficient for HIV diagnosis in AIDS­endemic areas of central Africa where prevalence of mycobacterial diseases is quite high'.

These findings are exactly in line with the Krynens' observations, with what Father D'Agostino originally allowed himself to see, and with the Eleopulos paper in Bio/Technology. They go to the root of the bad science that has misled so many into believing Africa is in the grip of an epidemic of 'HIV disease'. The disease is in the minds of the scientists responsible for creating this monumental blunder, and for perpetuating it with campaigns to discredit those who have sought to offer an alternative perspective

'AIDS' in Africa is a collection of illnesses, some well known, others perhaps yet to be identified, brought together under an artificial umbrella by their shared ability to cause millions to give a positive result in what has come to be known as the HIV test.

As Professor P.A.K. Addy, head of clinical microbiology at the University of Science and Technology in Kumasi, Ghana, told New African magazine: 'I've known for a long time that AIDS is not a crisis in Africa as the world is being made to understand. But in Africa it is very difficult to stick your neck out and say certain things. The West came out with those frightening statistics on AIDS in Africa because it was unaware of certain social and clinical conditions. In most of Africa, infectious diseases, particularly parasitic infections, are common. And there are other conditions that can easily compromise or affect one's immune system.

'The diagnosis itself, merely being told you have AIDS, is enough to kill, and is killing people'.

I salute the Krynens, and others like them in Africa and elsewhere, who have been prepared to risk everything for the sake of telling the truth as they see it. *